Law & Regulations

Cooperation with Committee and Assessors

Every member shall co-operate with the Quality Assurance Committee and with any assessor it appoints and in particular every member shall: -permit the assessor to enter and inspect the premises -permit the assessor to inspect the member's records -give the Committee or assessor the information in respect of the care of the patients or the member's records of the care -participate in a program designed to evaluate the knowledge, skill and judgement of the member

Annual Reports

monitor and evaluate processes and outcomes shall annually submit these to Council

Minister of Health

Administers the Regulated Health Professionals Act (RHPA) Ensures health professions are regulated and co-ordinated in the public interest standards are practice are developed and maintained

College Council

CMTO headed by a board of Directors elected professional members and members of the public appointed by the Minister of Health Administer Regulated Health Professions Act

Reporting Child Abuse or Neglect

Child and Family services requires any person who performs professional or official duties with respect to children, who has reasonable grounds to suspect; The child is suffered or likely to suffer physical harm inflected by the person having charge of the child, the child has been sexually molested/exploited or there is a risk they are likely to be by the person having charge or that that person knows they are to be, child requires medical treatment that and it is refused/unavailable, child has suffered or at risk of suffering emotional harm and assistance is refused or unavailable, abandonment, the child is under 12 and has killed or seriously injured another or damaged property. Report should be made by the reporting individual to the local Children's Aid Society.

Consent

Consent to Treatment Act 1996 No age that determines when an individual is deemed capable, depends on persons ability to understand the situation and treatment proposed. Must relate to the treatment being proposed, be informed, be voluntary and must not be obtained through misrepresentation or fraud. Must explain, nature of treatment, benefits, risks and side effects, consequences of no treatment.

Handling of records

Health information custodian shall ensure that the records of personal health information are retained, transferred and disposed of in a secure manner. (ie. shredding of secure documents).

26 Regulatory

How many Health _____ bodies: Such as Audiology & Speech Language Path, Chiropody, Chiro, Dental Hygiene, Dentistry, Dental Tech, Denturism, Dietetics, Homeopathy, Kinesiology, Pharmacy, Psych, Respiratory Therapy, Med Lab Tech, Med Rad Tech, Midwifery, Naturopathy, Occupational Therapy, Optometry, Physio, Psycho, TCM

Heath Information Security

Custodian shall take steps to ensure that personal health information in custody or control is protected against theft, loss and unauthorized use or disclosure and to ensure that the records containing the information are protected against unauthorized copying, modification or disposal.

Professional Misconduct

Decided by panel of Discipline Committee member found guilty of an offense relevant to suitability to practice member failed to co-operate with QA committee or assessor appointed member has sexually abused a patient

False

True or False. Use of other title, term or designation that implies the member is a specialist in any aspect of massage therapy is permitted?

$160

Fee to maintain inactive CMTO membership

$600

Fee to reactivate CMTO membership if lapsed

Release of records

Request is made for information from a clients file: -signed consent (within 6 months) -therapist may request a payment of fee prior to providing documentation

$100

Late fee for CMTO membership

Duty of the College

work in consultation with Minister to ensure Ontarians have access to adequate members of qualified, skilled and competent regulated health professionals

Certificate of Registration

-Only one wall and one photo ID -May not be transferred, photocopied or duplicated in any manner -May not rent or sell to anyone for any purpose -Must be returned to the College when registration expires or is revoked -MT's responsibility to protect wall and photo from fraudulent use

RHPA College Complaints Process

1.Reaches registrar - filed with ICRC 2.Panel for investigation is formed - panel selected by ICRC 3.Complaint must be written/recorded on permanent medium 4.Registrar gives notice to complainant that complaint has been received 5.Within 14 days - Registrar gives member notice of complaint and that the panel is investigating - informs member that they may respond in writing. 5b. ADR 6.After investigation the panel may refer out to ICRC or discipline committee 7. Notice of decision - copy to complainant and member with decision and reason and right to request an independent review

Retention of records

A health information custodian that has custody or control of personal health information that is the subject of a request for access shall retain information for as long as necessary. Records may be kept in an individual's home with consent, and in other places if records are kept in a reasonable manner, the individual consents, the practitioner is permitted to keep the record in the place in accordance with a regulation, by-law or published guideline

Dual relationship

A massage therapist who also provides massage therapy to a family member. The therapist is in two significantly different relationships with that person, this is considered what?

Incapacitated

A member is believed to be _____ if member is suffering from a physical/mental disorder best interest that the member's practice be subject to terms/cond/limitations or no longer able to practice Registrar can make inquiries ICRC appoints panel to inquire in investigation

Self Reporting

A member shall file in writing if the member has been found guilty of an offense. The report must be filed as soon as reasonably practical after the member receives notice of the finding of guilt. Also pertinent to report Risk of harm to self or other.

Incompetence

A panel shall find the member_____ if the member's professional care of a patient displayed a lack of knowledge, skill or judgment.

Capacity to give consent

A person is capable with respect to a treatment, admission to a care facility or a personal assistance service if the person is able to understand the information that is relevant to making a decision about the treatment, admission or personal assistance service and able to appreciate the reasonably foreseeable consequences of a decision or lack of decision.

Principles of giving or refusing consent

A person who gives/refuses consent on an incapable person's behalf should do so; If the person knows of a wish applicable to the circumstances (person must be 16) If wish unknown the person must still be 16 and will act on their behalf.

Financial

Abuse that includes the inappropriate use of a client's funds, property or resources.

Sexual

Abuse that is defined as sexual intercourse or other forms of physical sexual relations between the member & patient, touching of a sexual nature of the patient by a member or behavior or remarks of a sexual nature towards the patient.

Verbal

Abuse that may include rude, sarcastic, demeaning or seductive remarks. Members must be aware that age, culture, socioeconomic status and particular sensitivities affect how a client may perceive communications.

Physical

Abuse that uses unnecessary force in the course of providing treatment.

Emotional

Abuse where a member of the profession uses the position of power to intimidate or show insensitivity toward the client.

Treatment

Anything done for a therapeutic, preventive, palliative, diagnostic, cosmetic or other health related purpose, including a course of treatment or plan of treatment.

Complaints

ICRC comprised of public or professional members of Council Committee determines whether the MT's services were professionally and competently rendered ICRC no authority to assess injury/demand refund or apology or award damages College will not process anonymous complaints all information relating to investigation is confidential

Interim suspension

ICRC may make an interim order directing the Registrar to suspend or impose terms/cond/limitations on a certificate if - allegation of sexual abuse is referred to the Discipline Committee, or it is of the opinion that the conduct of the member exposes or is likely to expose his or her patients to harm or injury.

Personal Health Information

Identifiable information relating to your health and health care history. Information that may be included by your health record such as diagnostic, treatment and care information, your OHIP number, and genetic info. Includes any other identifying information included.

Discipline Protocol

If a panel finds a member has committed an act of professional misconduct; Direct Registrar to revoke certificate, suspend certificate, impose terms/cond/limitations Require the member to appear before the panel to be reprimanded Require member to pay a fine max $35,000 If sexual abuse - member to reimburse college for funding provided under Client Relations Program

1 year, 5 years

If applying to have suspension removed member may apply for reinstatement after what period?

Methods of Protection

If documents are electronic: -physical measures, such a locked filing cabinets -security clearances -passwords and encryption -maintaining confidentiality

$25,000

If found guilty on conviction of a controlled act offense for the first time, the person could face a fine of how much? Plus prison for up to 1 year. The second offense is a $50,000, prison for up to 1 year.

Divisional Court

If found unfit to practice the member may appeal to where? This is a branch of the Superior Crt of Justice. These appeals are usually heard in region where the matter arose. All judgements from Discipline, Fit to Practice are appealed here.

Physical/Mental Examinations

If reason to believe member is incapacitated they may need to submit what? After this report panel may refer to Fit to Practice committee.

Plan of treatment

If this is to be proposed for a person one health practitioner may on behalf of a team propose the plan of treatment determine the persons capacity with respect to treatments referred to in the plan Obtain consent or refusal - from the person or substitute decision maker

Best Interest

In deciding what the incapable person's best interests are their person shall take into consideration; values and beliefs wishes expressed by incapable person If treatment is likely to - improve/prevent deterioration/reduce deterioration of the persons condition If the condition is likely to improve, remain the same or deteriorate without treatment Benefit outweighs the risk If a less intrusive/restrictive treatment would be beneficial

Health Information Custodian

Includes doctors, other health care practitioners, hospitals, and long term care facilities. Includes health care clinics, laboratories, pharmacies, Ministry of Health and Long Term Care and other health related organizations. Applies to individuals and organizations outside of health system such as insurance companies and employers.

Substitute Decision Maker

Individuals who make treatment decisions for individuals who are not capable of making them independently. Most cases a family member. Act in the client's best interests and make decisions consistent with client's last known wishes. Hierarchy; official court appointed guardian attorney for personal care representative appointed by the Consent and Capacity Review Board a spouse, partner or relative, 16 years or older, custodial parent, parent with right of access, brother or sister, any other relative

Yes

Is the health care provider able to report someone they think is at risk of spreading a communicable disease?

Reporting Sexual Abuse

Mandatory under the RHPA for a RMT to file a written report tot he College if they have reasonable grounds to believe that a patient has been sexually abused by an member of the CMTO. Exception if they do not know the name of the member. The patients name not included unless consent given and advise patient of requirement to report. Must be in writing and filed within 30 days or immediately.

Maintenance of Client Records

Massage Therapists are required to: -make and maintain records relating to provision of services -maintain client records for up to 10 years or if client is less than 18, 10 years from the date the client turns 18 -ensure confidentiality -release information with the client's consent

Titles

Massage therapist who have been issued a certificate of registration by the College are entitled to use the protected _____ and trademarks that indicate their registration with the College. These are (M.T., RMT, Massage Therapy, Therapeutic Massage). Recommends that academic degrees or certificates be used after and in conjunction with...

Records

Member shall take reasonable steps to ensure that: -Verification at reasonable intervals -Daily appointment with name of each clients -Equipment service record -Financial records -Client health records -Must be kept by means of optical or electronic storage

30

Members must obtain a minimum of how many CEU (continuing education credits) each credit cycle. Credit cycle begins Nov 1 that follows the day the person becomes a member and sever subsequent three-year period.

Mandatory Articles

Members must read and respond to three (1 CEU per year for 3 articles answered). Designated article in each issue of the Collage Standard and composing a response to questions in the article.

Advertising

Must not contain: -anything that is false or misleading -anything that cannot be verified -endorsements from organizations not known to have expertise relevant to the subject matter -testimonials by clients/former clients/friends or relatives -claims or guarantees -must be readily comprehensible to the persons to whom it is directed -person who is responsible must identify themselves as a member of the college may contain information about the practice, identification of the educational qualifications of the staff and info on the types of services available

Record retention policy

No agreement between or among massage therapists or between a massage therapist and other health care providers can supersede the individual massage therapist's duty to a client with respect to keeping health records. When commencing employment or entering into a group practice should develop an agreement that explicitly covers procedures for record storage, covering: Termination of employment/partnership or agreement Closing/relocating/selling of the practice

Mandatory Reporting

Obligation under the RHPA and the Health Professions Procedural Code for RMT, employers and facility operators to file written reports to the College in a number of circumstances. Essential to professional obligation because it is the best means of ensuring that instances of professional misconduct, incompetence, professional negligence, sexual abuse or concerns regarding incapacity are brought to the attention of the College.

Record Offense

Person is guilty of an offense if: -person willfully collects/uses/discloses personal health information -makes a request under this act under false pretenses in connection with collection, use or disclosure of personal health info or access to a record makes an assertion knowing that it is untrue -disposes of a record with intent to evade a request for access -makes a false statement to mislead or attempt to mislead the commissioner -fails to comply an order of the Commissioner Penalty of an offense fine not more than $50,000 if a corporation max $250,000

Quality Assurance Program

Professional portfolio: Self Assessment and Professional Activity Log Credits component Peer assessment and remediation of a member's practice This program is called what?

Sexual Abuse Provisions

Purpose of this provision is to: Encourage reporting Provide funding for therapy/counseling Te eradicate the issue

Purpose

Quality Assurance Program is to evaluate that the member's knowledge, skills and judgement adhere to the Standards of Practice.

Required to Report

Sexual Abuse by a member of a health profession, Negligence, malpractice or guilty findings, Suspected Child Abuse, Suspected Elder Abuse, Suspected Incompetence or incapacity of a therapist or employee.

Zero Tolerance

The CMTO recognizes the seriousness and extent of injury that abuse cause the client and others related to the client. Form of abuse such as verbal, physical, emotional, financial or sexual by a massage therapist fall under this heading.

1 year

The College advises that massage therapists should not enter into a sexual relationship with a former client for a period of how long following the date of the last professional contact with the client.

Examinations

The College shall specify the general areas of competency Written and practical shall be offered at least twice yearly Candidate who fails may apply for re-examination - 3 times max if after third must obtain another diploma

1991

The Regulated Health Professions Act and the Massage Therapy Act were created in what year?

Sensitive Areas

The chest wall musculature, breast tissue, inner thigh, gluteal region are considered what? Therapists should be careful to obtain and record verbal consent for all procedures. This does not discourage a a therapist from creating an alternative Consent form to sign.

Elements of Consent

The consent must relate to the treatment The consent must be informed The consent must be given voluntarily The consent must not be obtained through misrepresentation or fraud

Committees

The following are what to the CMTO; Executive, Registration, Inquiries Complaints and Reports, Discipline, Fitness to Practice, Quality Assurance, Patient Relations

Scope of Practice

The practice of massage therapy is the assessment of the soft tissue and joints of the body and the treatment and prevention of physical dysfunction and pain of the soft tissues and joints by manipulation to develop, maintain, rehabilitate or augment physical function, or relieve pain.

Reporting of Suspected Elder Abuse

Under the Nursing Homes Act if a person has reasonable grounds to suspect that a resident has suffered or may suffer harm as a result of unlawful conduct, improper or incompetent treatment care or neglect, shall immediately report the suspicion and information to the Director of Nursing Homes. In provincially funded nursing homes should be made to the Ministry of Health and Long-Term Care, in privately funded nursing homes to the Ministry of Consumer and Commercial Relations, Companies Branch.

Regulated Health Professions Act (RHPA)

What gives authority to the CMTO to make regulations, set standards and policies for its area of responsibility?

CMTO

Who establishes policy and Guidelines for profession, cert. exams, Info on becoming an RMT, Public Register, Quality Assurance, Public Ed., Media relations, Professional Ed., Publications, Complaints and Discipline?

$555

Yearly CMTO membership fee

Removing Info from the Register

all info remains indefinitely pardon like process if asking for information to be removed (unless sexual abuse)

Policy Statements

articulate the council's opinion and position on specific issues relating to the practice of massage therapy

Health Professions Appeal and Review

complaint review by this group 3 board members meet with complainant and member and rep from regulatory college Judge - adequacy of investigation by ICRC, & reasonableness of committee decision open to public and comments are allowed Board can require committee to further investigate

Registrar

council shall appoint an employee to perform this function

Patient Relations Committee

develop and administer the program develop education required and guidelines for professional interaction between members and clients develop program for promoting public knowledge (sex abuse) ensure regulatory functions are accessible provide council and Reg. Advisory Council with written reports administer funding program to provide therapy/counseling for clients who were sexually abused verify the above program

Advisory Council

established under the name Health Professions Regulatory Advisory Council duty is to advise the Minister decide whether unregulated professions should be regulated or no longer suggest amendments to the act advise on matters concerning Quality assurance programs by colleges monitor college's patient relations program and advise minister of effectiveness

Registration Committee

evaluate foreign trained applicants evaluate other non-standard applications (incl. inactive members) review request from Registrar for imposition of terms/conditions or limitations on a certificate

Discipline Committee

hold hearing of all allegations of misconduct refrain from sitting on a panel if there was involvement of investigation make judgements/orders for revocations or suspensions or order impositions of terms/conditions and limitations

Inquires Complaints and Reports Committee

investigate all complaints (direct or referred by committees) form boards of inquiry follow up on mandatory reporting (sexual, self, child) refer to discipline committee (sexual, misconduct, incompetence) refer member to another panel for incapacity refer to Fitness to Practice for incapacity require member to appear before a panel to be cautioned invite/order therapist to mediate certain aspects of practice require member to complete - con't ed or remediation if complaint is frivolous/vexatious notify member and complainant the no action will be taken ICRC may dismiss the case Inform client of their right to appeal to HPARB

College Register

maintains: members name/business address/tele & corporation the member is a shareholder of name/business # of every health professional corp names of shareholders of each health prof. who are members members class of reg. and membership status terms/cond/limitations in effect on each certificate notifications of matters refered to Inqu/Comp/Reports and Discipline (results/synopsis of decision) notation of every revocation/suspension info that the Reg/Discipline and Fit to Practice specifies should be included if finding of Discipline committee are appealed - notation under appeal results of proceeding a member resigned and agreed never to practice again

Executive Committee

manage business when council is not in session report actions to council

Alternate Dispute Resolution

mediation/conciliation/negotiation or other means to resolve college offers voluntary and confidential program for resolution of some complaints not suitable for all complaints (ie. professional misconduct, sexual abuse, dishonesty or fraud)

Appeals Committee

meet after each exam after the 30 day limit for appeals relevant to the exam admin process hear all appeals related to the exam process

Restricted Controlled Acts

must not perform controlled acts unless authorized by a health profession act ie. diagnosing, procedure on tissue beneath the dermis, setting bones, moving joints of the spine, administering injections/inhalants, prescribing/dispensing/selling drugs/eye problems managing labour/delivering a baby, allergy testing, psychotherapy

Guidelines

provide a more detailed description of the way in which a policy or position is translated into practice -provide guidance to members

Position Statements

provide the collective opinion and position on specific issues relating to the practice of massage therapy

CMTO (College of Massage Therapist of Ontario)

provincial regulatory agency that exists to protect the public interest and regulate the profession enforces competency & quality of care directed by a council of elected members and those appointed by the ministry of health

Objective of Regulatory Health Colleges

regulate the practice of the profession and govern members develop/establish/maintain standards of qualifications develop/establish/maintain programs and standards of practice develop/establish/maintain standards of knowledge skill and programs to promote competence

Registered Massage Therapists Association of Ontario (RMTAO)

represent and serve its members and advance the profession Influencing and communicating change, conference and seminars, liability insurance, optional group benefits, publications, networking, media relations, referral service, promotional materials, job search.

Quality Assurance Committee

require those who have been assessed and to be found unsatisfactory to participate in con't ed direct the registrar to impose terms/cond or limitations for a specified period to be determined by the committee on the certificate of a reg. member direct the registrar to remove terms/cond or limitations disclose the name of the member and allegations to the Inq/Com and Reports Committee if Q/A is of the opinion that a member may have committed misconduct/incompetence or incapacitated may appoint assessor for the purpose of Q/A program

registration

the CMTO requires the following in order for what; pass written and practice exam (OSCE) be fluent in English or french hold min $2million liability insurance current CPR/First Aid Pay yearly registration fees 500hrs of client care within 3yrs or 3yr massage therapy program or 12month refresher course criminal record check diploma from accredited program Canadian citizen, landed immigrant Certify that you have a principle place of practice``

Fitness to Practice Committee

to hear any matter concerning the capacity of a member referred by Inqu./Complaints and Reports Com. render decisions concerning members capacity to practice order revocations, suspensions or impose terms/conditions, limitations inform the therapist of their right to appeal to Divisional Court